Retaining family physicians in comprehensive primary care: Scoping review.

Abstract

Objective: To identify evidence of strategies, initiatives, or policies in the literature aimed at retention of family physicians in comprehensive family practice.

Data sources: Electronic databases (Embase, MEDLINE, EBSCOhost) and grey literature sources were searched for relevant articles published from 2000 to February 17, 2023, with study participants that included family physicians and general practitioners in comprehensive primary care practice. Retention strategies, initiatives, and policies were the primary concepts identified.

Study selection: Independent title and abstract screening and full-text assessment were completed using Covidence software, with conflicts discussed between 2 reviewers. This was followed by thematic analysis to identify themes and synthesize evidence. Twenty-three articles that described strategies for retaining primary care physicians in practices were selected. Most studies were conducted in the United States, Canada, and Australia, with a few in each of Brazil, Japan, and in 2 European countries (18 using quantitative, qualitative, and mixed methods approaches with the remaining 5 articles being case descriptions or letters to the editor).

Synthesis: Five categories of retention strategies were identified: embedding in medical training, community integration, financial support, professional and personal supports, and organizational environment. Early exposure for medical students and residents to rural or underserved communities through distributed medical education, and integration within a community that encouraged the development of ties both professionally and personally both had a positive impact on retention. Supports including financial incentives, professional growth opportunities, and organizations that fostered collaboration among family physicians were also seen to encourage long-term practices.

Conclusion: More research is needed to identify effective strategies or policies aimed at retaining family physicians in comprehensive care practice and to foster healthy and productive careers for professionals who may desire to exit earlier than intended due to systemic issues. Governments need to focus on retaining well-educated and dedicated doctors and encourage lifelong careers in comprehensive family medicine.